Corticosteroids vs Glucocorticoids: What's the Difference?

Corticosteroid is a class of steroids mimicking the actions of endogenous glucocorticoids, the hormones naturally synthesized by the adrenal cortex, which sits on top of the kidney. Commonly known as “steroids,” these medications are used to treat a wide range of medical conditions and autoimmune diseases due to their anti-inflammatory and immunosuppressive effects. Corticosteroid therapy’s anti-inflammatory effects make these medications valuable in managing the signs and symptoms of asthma, rheumatoid arthritis, lupus, allergic disorders, psoriasis, inflammatory bowel disease, and several other health conditions. Steroids work to reduce inflammation, in turn, alleviate pain, redness, and swelling associated with inflamed tissues.

What are the adrenal glands?

The adrenal glands are small, triangular-shaped glands located on top of each kidney. They produce hormones that regulate many essential functions in the body, including metabolism, blood pressure, the immune response, and the stress response. The adrenal glands are divided into two areas called the adrenal cortex and the adrenal medulla. Each of these areas produces specific hormones.

What is the difference between corticosteroids and glucocorticoids?

The term corticosteroid is used to describe hormones made by the adrenal cortex. This includes two types of hormones called glucocorticoids and mineralocorticoids.

Therefore, a glucocorticoid is a type of corticosteroid. All glucocorticoids are corticosteroids. However, not all corticosteroids are glucocorticoids. Corticosteroids can be either glucocorticoids or mineralocorticoids.

What are the two types of corticosteroids?

As mentioned, corticosteroids (also called steroids) are hormones produced by the cortex area of the adrenal glands. There are primarily two types: glucocorticoids and mineralocorticoids. In general, glucocorticoids control sugar, and mineralocorticoids control salt intake. However, the following explanations will give you more insight into their specific roles, not limited to this broad generalization.

Glucocorticoids include the hormone cortisol. This hormone plays several important roles in the body. It has an immunosuppressive effect, meaning it suppresses immune function through its anti-inflammatory effect by increasing anti-inflammatory proteins. Additionally, cortisol (glucocorticoid) effects include the regulation of carbohydrate metabolism, blood pressure, blood sugar, bone formation, the sleep-wake cycle, and the stress response.

Mineralocorticoids include a hormone called aldosterone. This hormone is responsible for controlling blood pressure and sending signals to the kidneys to regulate sodium levels.

Other hormones produced by the adrenal cortex include DHEA and anabolic steroids. Some bodybuilders use synthetic anabolic steroids, which are used as precursors (building blocks) of the male sex hormone testosterone to increase muscle mass.

The adrenal medulla makes hormones called epinephrine (adrenaline) and norepinephrine (noradrenaline), which control the “fight or flight response” and other body functions like heart rate, blood flow to the brain and muscles, glucose metabolism, etc.

Is prednisone a glucocorticoid or a corticosteroid?

Prednisone is a synthetic glucocorticoid. All glucocorticoids are corticosteroids. Synthetic glucocorticoids are available as oral corticosteroids (tablets, capsules), topical steroids (creams, ointments, gels, lotions), steroid injections (cortisone shots), and inhalers (mouth or nasal sprays).

Furthermore, steroid therapy helps reduce inflammation and is used to treat a wide range of conditions, such as rheumatoid arthritis, systemic lupus erythematosus, and others. Corticosteroid therapy is also used for replacement therapy in people with adrenal insufficiency (Addison’s disease), in which the adrenal glands do not make enough hormones to support the body’s functions, as was listed above when explaining the role of the different corticosteroids.

What are the risks of taking corticosteroids?

Glucocorticoids act on many body systems. As a result, taking high or long-term corticosteroids (glucocorticoids or mineralocorticoids) comes with an increased risk of serious health complications.

Some of the adverse effects of oral steroids include acne, unwanted hair growth, skin atrophy (thin skin), weight gain, high blood pressure, impaired glucose tolerance (high blood sugar), Diabetes Mellitus, redistribution of adipose tissue (fat), mood changes, psychiatric disorders, congestive heart failure, muscle weakness, bone loss, and impaired wound healing. These risks depend on glucocorticoid potency and the duration of treatment (meaning, the side effects are more with high doses or prolonged use).

Steroid therapy carries other risks as well. For example, the use of systemic glucocorticoids by pregnant women can increase the risk of birth defects. Corticosteroid therapy can also increase the risk of systemic fungal infections and bacterial infections because these drugs suppress the immune system and can increase blood sugar. Additionally, prolonged treatment with steroid therapy can lead to adrenal suppression, where the adrenal glands stop making their natural amount of steroid hormones that support bodily functions. Combining corticosteroids with certain other drugs can lead to serious side effects due to drug interactions.

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